Increasingly, colleges across the world are contending with rising rates of mental disorders, and in many cases, the demand for services on campus far exceeds the available resources. The present ...study reports initial results from the first stage of the WHO World Mental Health International College Student project, in which a series of surveys in 19 colleges across 8 countries (Australia, Belgium, Germany, Mexico, Northern Ireland, South Africa, Spain, United States) were carried out with the aim of estimating prevalence and basic sociodemographic correlates of common mental disorders among first-year college students. Web-based self-report questionnaires administered to incoming first-year students (45.5% pooled response rate) screened for six common lifetime and 12-month DSM-IV mental disorders: major depression, mania/hypomania, generalized anxiety disorder, panic disorder, alcohol use disorder, and substance use disorder. We focus on the 13,984 respondents who were full-time students: 35% of whom screened positive for at least one of the common lifetime disorders assessed and 31% screened positive for at least one 12-month disorder. Syndromes typically had onsets in early to middle adolescence and persisted into the year of the survey. Although relatively modest, the strongest correlates of screening positive were older age, female sex, unmarried-deceased parents, no religious affiliation, nonheterosexual identification and behavior, low secondary school ranking, and extrinsic motivation for college enrollment. The weakness of these associations means that the syndromes considered are widely distributed with respect to these variables in the student population. Although the extent to which cost-effective treatment would reduce these risks is unclear, the high level of need for mental health services implied by these results represents a major challenge to institutions of higher education and governments.
General Scientific Summary
Roughly 1/3 of first-year students in 19 colleges across 8 countries who participated in a self-report survey screened positive for at least 1 common DSM-IV anxiety, mood, or substance disorder (35.3% lifetime, 31.4% 12 months). Basic sociodemographic correlates were modest, showing that the syndromes were widely distributed rather than concentrated in 1 small segment of the student population.
Objective
In gout, hyperuricemia promotes urate crystal deposition, which stimulates the NLRP3 inflammasome and interleukin‐1β (IL‐1β)–mediated arthritis. Incident gout without background ...hyperuricemia is rarely reported. To identify hyperuricemia‐independent mechanisms driving gout incidence and progression, we characterized erosive urate crystalline inflammatory arthritis in a young female patient with normouricemia diagnosed as having sufficient and weighted classification criteria for gout according to the American College of Rheumatology (ACR)/EULAR gout classification criteria (the proband).
Methods
We conducted whole‐genome sequencing, quantitative proteomics, whole‐blood RNA‐sequencing analysis using serum samples from the proband. We used a mouse model of IL‐1β–induced knee synovitis to characterize proband candidate genes, biomarkers, and pathogenic mechanisms of gout.
Results
Lubricin level was attenuated in human proband serum and associated with elevated acute‐phase reactants and inflammatory whole‐blood transcripts and transcriptional pathways. The proband had predicted damaging gene variants of NLRP3 and of inter‐α trypsin inhibitor heavy chain 3, an inhibitor of lubricin‐degrading cathepsin G. Changes in the proband's serum protein interactome network supported enhanced lubricin degradation, with cathepsin G activity increased relative to its inhibitors, SERPINB6 and thrombospondin 1. Activation of Toll‐like receptor 2 (TLR‐2) suppressed levels of lubricin mRNA and lubricin release in cultured human synovial fibroblasts (P < 0.01). Lubricin blunted urate crystal precipitation and IL‐1β induction of xanthine oxidase and urate in cultured macrophages (P < 0.001). In lubricin‐deficient mice, injection of IL‐1β in knees increased xanthine oxidase–positive synovial resident M1 macrophages (P < 0.05).
Conclusion
Our findings linked normouricemic erosive gout to attenuated lubricin, with impaired control of cathepsin G activity, compounded by deleterious NLRP3 variants. Lubricin suppressed monosodium urate crystallization and blunted IL‐1β–induced increases in xanthine oxidase and urate in macrophages. The collective activities of articular lubricin that could limit incident and erosive gouty arthritis independently of hyperuricemia are subject to disruption by inflammation, activated cathepsin G, and synovial fibroblast TLR‐2 signaling.
Objectives
Mental disorders and suicidal thoughts and behaviors (STB) are common and burdensome among college students. Although available evidence suggests that only a small proportion of the ...students with these conditions receive treatment, broad‐based data on patterns of treatment are lacking. The aim of this study is to examine the receipt of mental health treatment among college students cross‐nationally.
Methods
Web‐based self‐report surveys were obtained from 13,984 first year students from 19 colleges in eight countries across the world as part of the World Health Organization's World Mental Health–International College Student Initiative. The survey assessed lifetime and 12‐month common mental disorders/STB and treatment of these conditions.
Results
Lifetime and 12‐month treatment rates were very low, with estimates of 25.3–36.3% for mental disorders and 29.5–36.1% for STB. Treatment was positively associated with STB severity. However, even among severe cases, lifetime and 12‐month treatment rates were never higher than 60.0% and 45.1%, respectively.
Conclusions
High unmet need for treatment of mental disorders and STB exists among college students. In order to resolve the problem of high unmet need, a reallocation of resources may focus on innovative, low‐threshold, inexpensive, and scalable interventions.
The oxidation of aqueous solutions containing Allura Red AC (AR–AC) using bicarbonate-activated peroxide (BAP) and cobalt-impregnated pillared clay (Co/Al–PILC) as the catalyst was investigated. ...Using the CCD-RMS approach (central composite design–response surface methodology), the effects of dye, H2O2, and NaHCO3 concentrations on AR–AC degradation were studied. The decolorization, total nitrogen (TN), and total carbon (TC) removals were the analyzed responses, and the experimental data were fitted to empirical quadratic equations for these responses, obtaining coefficients of determination R2 and adjusted-R2 higher than 0.9528. The multi-objective optimization conditions were dye = 21.25 mg/L, H2O2 = 2.59 mM, NaHCO3 = 1.25 mM, and a catalyst loading of 2 g/L. Under these conditions, a decolorization greater than 99.43% was obtained, as well as TN and TC removals of 72.82 and 18.74%, respectively, with the added advantage of showing cobalt leaching below 0.01 mg/L. Chromatographic analyses (GC–MS and HPLC) were used to identify some reaction intermediates and by-products. This research showed that wastewater containing azo dyes may be treated using the cobalt-catalyzed BAP system in heterogeneous media.
Identification of the emerging multidrug-resistant yeast
Candida auris
is challenging. Here, we describe the role of the Mexico national reference laboratory Instituto de Diagnóstico y Referencia ...Epidemiológicos Dr. Manuel Martínez Báez (InDRE) and the Mexican national laboratory network in the identification of
C. auris
. Reference identification of six suspected isolates was done based on phenotypic and molecular laboratory methods, including growth in special media, evaluation of isolate micromorphology, and species-specific PCR and pan-fungal PCR and sequencing. The four
C. auris
isolates identified were able to grow on modified Sabouraud agar with 10% NaCl incubated at 42 °C. With one exception, isolates of
C. auris
were spherical to ovoid yeast-like cells and blastoconidia, with no hyphae or pseudohyphae on cornmeal agar.
C. auris
isolates were resistant to fluconazole. Species-specific and pan-fungal PCR confirmed isolates as
C. auris
. Sequence analysis revealed the presence of two different
C. auris
clades in Mexico, clade I (South Asia) and clade IV (South America).
An incomplete understanding of the immunological mechanisms underlying protection against tuberculosis (TB) hampers the development of new vaccines against TB. We aimed to define host correlates of ...prospective risk of TB disease following bacille Calmette-Guérin (BCG) vaccination.
In this study, 5,726 infants vaccinated with BCG at birth were enrolled. Host responses in blood collected at 10 weeks of age were compared between infants who developed pulmonary TB disease during 2 years of follow-up (cases) and those who remained healthy (controls).
Comprehensive gene expression and cellular and soluble marker analysis failed to identify a correlate of risk. We showed that distinct host responses after BCG vaccination may be the reason: two major clusters of gene expression, with different myeloid and lymphoid activation and inflammatory patterns, were evident when all infants were examined together. Cases from each cluster demonstrated distinct patterns of gene expression, which were confirmed by cellular assays.
Distinct patterns of host responses to Mycobacterium bovis BCG suggest that novel TB vaccines may also elicit distinct patterns of host responses. This diversity should be considered in future TB vaccine development.
Objective
The objective of this study is to assess the contribution of mental comorbidity to role impairment among college students.
Methods
Web‐based self‐report surveys from 14,348 first‐year ...college students (Response Rate RR = 45.5%): 19 universities, eight countries of the World Mental Health International College Student Initiative. We assessed impairment (Sheehan Disability Scales and number of days out of role DOR in the past 30 days) and seven 12‐month DSM‐IV disorders. We defined six multivariate mental disorder classes using latent class analysis (LCA). We simulated population attributable risk proportions (PARPs) of impairment.
Results
Highest prevalence of role impairment was highest among the 1.9% of students in the LCA class with very high comorbidity and bipolar disorder (C1): 78.3% of them had severe role impairment (vs. 20.8%, total sample). Impairment was lower in two other comorbid classes (C2 and C3) and successively lower in the rest. A similar monotonic pattern was found for DOR. Both LCA classes and some mental disorders (major depression and panic, in particular) were significant predictors of role impairment. PARP analyses suggest that eliminating all mental disorders might reduce severe role impairment by 64.6% and DOR by 44.3%.
Conclusions
Comorbid mental disorders account for a substantial part of role impairment in college students.
Wiskott-Aldrich syndrome protein-deficient patients and mice are immunodeficient and can develop inflammatory bowel disease. The intestinal microbiome is critical to the development of colitis in ...most animal models, in which Helicobacter spp. have been implicated in disease pathogenesis. We sought to determine the role of Helicobacter spp. in colitis development in Wiskott-Aldrich syndrome protein-deficient (WKO) mice.
Feces from WKO mice raised under specific pathogen-free conditions were evaluated for the presence of Helicobacter spp., after which a subset of mice were rederived in Helicobacter spp.-free conditions. Helicobacter spp.-free WKO animals were subsequently infected with Helicobacter bilis.
Helicobacter spp. were detected in feces from WKO mice. After rederivation in Helicobacter spp.-free conditions, WKO mice did not develop spontaneous colitis but were susceptible to radiation-induced colitis. Moreover, a T-cell transfer model of colitis dependent on Wiskott-Aldrich syndrome protein-deficient innate immune cells also required Helicobacter spp. colonization. Helicobacter bilis infection of rederived WKO mice led to typhlitis and colitis. Most notably, several H. bilis-infected animals developed dysplasia with 10% demonstrating colon carcinoma, which was not observed in uninfected controls.
Spontaneous and T-cell transfer, but not radiation-induced, colitis in WKO mice is dependent on the presence of Helicobacter spp. Furthermore, H. bilis infection is sufficient to induce typhlocolitis and colon cancer in Helicobacter spp.-free WKO mice. This animal model of a human immunodeficiency with chronic colitis and increased risk of colon cancer parallels what is seen in human colitis and implicates specific microbial constituents in promoting immune dysregulation in the intestinal mucosa.
College entrance may be a strategically well-placed "point of capture" for detecting late adolescents with suicidal thoughts and behaviors (STB). However, a clear epidemiological picture of STB among ...incoming college students is lacking. We present the first cross-national data on prevalence as well as socio-demographic and college-related correlates for STB among first-year college students.
Web-based self-report surveys were obtained from 13,984 first-year students (response rate 45.5%) across 19 colleges in 8 countries (Australia, Belgium, Germany, Mexico, Northern Ireland, South Africa, Spain, and the United States).
Lifetime prevalence of suicidal ideation, plans, and attempts was 32.7%, 17.5%, and 4.3%, respectively. The 12-month prevalence was 17.2%, 8.8%, and 1.0%, respectively. About three-fourths of STB cases had onset before the age of 16 years (Q3 = 15.8), with persistence figures in the range of 41% to 53%. About one-half (53.4%) of lifetime ideators transitioned to a suicide plan; 22.1% of lifetime planners transitioned to an attempt. Attempts among lifetime ideators without plan were less frequent (3.1%). Significant correlates of lifetime STB were cross-nationally consistent and generally modest in effect size (median adjusted odds ratio aOR = 1.7). Nonheterosexual orientation (aOR range 3.3-7.9) and heterosexual orientation with some same-sex attraction (aOR range 1.9-2.3) were the strongest correlates of STB, and of transitioning from ideation to plans and/or attempts (aOR range 1.6-6.1).
The distribution of STB in first-year students is widespread, and relatively independent of socio-demographic risk profile. Multivariate risk algorithms based on a high number of risk factors are indicated to efficiently link high-risk status with effective preventive interventions.
Background
Huntington disease is a fatal inherited neurodegenerative disease. Because the end result of Huntington disease is death due to Huntington disease-related causes, there is a need for ...better understanding and caring for individuals at their end of life.
Aim
The purpose of this study was to develop a new measure to evaluate end of life planning.
Design
We conducted qualitative focus groups, solicited expert input, and completed a literature review to develop a 16-item measure to evaluate important aspects of end of life planning for Huntington disease. Item response theory and differential item functioning analyses were utilized to examine the psychometric properties of items; exploratory factor analysis was used to establish meaningful subscales.
Participants
Participants included 508 individuals with pre-manifest or manifest Huntington disease.
Results
Item response theory supported the retention of all 16 items on the huntington disease quality of life (“HDQLIFE”) end of life planning measure. Exploratory factor analysis supported a four-factor structure: legal planning, financial planning, preferences for hospice care, and preferences for conditions (locations, surroundings, etc.) at the time of death. Although a handful of items exhibited some evidence of differential item functioning, these items were retained due to their relevant clinical content. The final 16-item scale includes an overall total score and four subscale scores that reflect the different end of life planning constructs.
Conclusions
The 16-item HDQLIFE end of life planning measure demonstrates adequate psychometric properties; it may be a useful tool for clinicians to clarify patients’ preferences about end of life care.
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